Creation of the International Spine and Pain Consortium (ISPC) to Address Disc Degeneration and Low Back Pain

Low back pain is regarded as the most debilitating condition worldwide, representing tremendous socioeconomic and health-care burden. As such, this has peaked the interest by many in the medical and scientific community throughout the years to better understand the risk factors involved in the development, duration and recurrent nature of LBP. As such, disc degeneration of the lumbar spine has been identified as one of those factors. It has also been understood that disc degeneration is attributed to various determinants, such as genetics, environmental and lifestyle issues. However, to properly understand the clinical relevance of disc degeneration, one needs to understand how it is characterized. Unfortunately, the "phenotype" and assessment of disc degeneration, as has been reported time-and-time again in the literature, varies between investigative groups, is not standardized, and is not fully representative of the overall breakdown of the disc and surrounding elements.

The International Spine and Pain Consortium (ISPC) was established in June of 2013 as primarily a vehicle to bring together a multi-disciplinary group of spine experts involved in large-scale cohorts focusing on disc degeneration and other spine abnormalities as well as various pain profiles to address spine degeneration and pain. This initiative was initially supported by a 2013 MacNab/LaRocca prize bestowed upon by the International Society for the Study of the Lumbar Spine (ISSLS) to the principal investigators Dr. Dino Samartzis, from the Department of Orthopaedics and Traumatology at the University of Hong Kong, and Professor Jaro Karppinen, from the Department of Physical and Rehabilitation Medicine at the University of Oulu, Finland, and their group of international collaborators. The first ISPC meeting was held in Hong Kong on June 28-29, 2013 and it addressed large-scale population-based cohorts assessing genetic epidemiology of disc degeneration and pain. Investigators from Europe and Asia participated in the inaugural meeting, representing cohorts consisting of the collection of advanced imaging, lifestyle/environmental factors, clinical parameters, and genetic data of thousands of subjects.

Dr. Samartzis, Co-Founder and Director of the ISPC, notes, "Understanding and treating disc degeneration and with that low back pain has taken center-stage by clinicians and scientists worldwide. Tremendous effort and funds have been spent throughout the years to elaborate on such platforms, which have not been without their challenge and in large part attributed to how disc degeneration and its severity as well as pain parameters were defined. In short, the phenotype of disc degeneration needs to be re-visited, re-classified, and standardized." He further notes, "Due to the complexities of why the chemistry and morphology of the disc changes and since its clinical relevance has in the past been elusive, large-scale, collaborative and systematic studies are needed to address genetic epidemiology of the disc and pain profiles." Co-Director of the ISPC, Professor Karppinen further notes, "The standardization of the phenotype of disc degeneration cannot be established by a single player but through a collaborative approach. This is the first task of the ISPC, which enables us to make advances in the fields of genetic epidemiology and treatment of spinal disorders." Dr. Samartzis further comments that "If we have a better understanding of the phenotype of disc changes and its pain parameters, this may help improve the development of preventative measures, novel diagnostics, cutting-edge biological therapies, and improved prognostic outcomes in an effort to have a more "personalized" approach to the spine."

Overall, the aim of the ISPC is to bring together a multi-disciplinary group of clinicians and scientists from around the world to address topical spine issues and cutting-edge research to advance the understanding of spinal disorders and improve patient care/outcomes. There are future plans to address other clinical and research platforms, such as pain genetics and its role in spinal conditions and therapeutic outcomes. Dr. Samartzis adds that "With the international spine community coming together and working on platforms of common interest and clinical importance, much more can be achieved than by working alone. This consortium is one of the first of its kind in the world and promises to set a new standard of international collaboration and high-impact studies." Additional information of the ISPC can be found at the following website, www.spine-consortium.org.